{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T10:17:49Z","timestamp":1791973069882,"version":"4.3.4"},"reference-count":51,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"3","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Oncology Practice"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:sec><jats:title>PURPOSE:<\/jats:title><jats:p> Young adult childhood cancer survivors (YACCSs) are often impacted by cancer-related cognitive impairment (CRCI) and psychological distress. Using the Project Forward Cohort, we evaluated the relationship between CRCI and substance use behaviors. <\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p> YACCSs were surveyed between 2015 and 2018 (N = 1,106, female = 50.8%, Hispanic = 51.5%, median age = 25.5 years). Associations between CRCI and substance use (tobacco, binge drinking, marijuana, prescription drug misuse, and e-cigarette\/vaporizer) were examined in multivariate logistic or log-binomial regressions, adjusting for child at diagnosis (0-14 years), years since diagnosis, sex, race\/ethnicity, cancer type, and treatment intensity. Mediation analysis was performed to determine opportunities for interventions. <\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p> CRCI was reported by 144 (13.0%) survivors. The highest prevalence was observed in CNS cancers (25.4%) and leukemia (13.3%) survivors. After covariate adjustment, CRCI was associated with 2.26 times the odds of prior 30-day vaping (95% CI, 1.24 to 4.11; P = .007). Mediators with significant indirect effects in the CRCI-vaping relationship include depressive symptoms (Center for Epidemiological Studies Depression Scale) and having two or more cancer-related late effects ( P &lt; .05). <\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION:<\/jats:title><jats:p> CRCI among YACCSs was associated with reports of vaping. Oncologists should screen for vaping behavior if CRCI is apparent. Increasing access to long-term follow-up clinics, addressing physical and mental health issues, and monitoring and educating on vaping and other substance use behaviors is recommended to improve the long-term health of YACCSs. <\/jats:p><\/jats:sec>","DOI":"10.1200\/op.22.00458","type":"journal-article","created":{"date-parts":[[2022,12,12]],"date-time":"2022-12-12T20:59:10Z","timestamp":1670878750000},"page":"e345-e354","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":14,"title":["Substance Use Among Young Adult Survivors of Childhood Cancer With Cognitive Impairment: An Analysis of the Project Forward Cohort"],"prefix":"10.1200","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0754-7901","authenticated-orcid":false,"given":"Ding Quan","family":"Ng","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy Practice, School of Pharmacy & Pharmaceutical Sciences, University of California Irvine, Irvine, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anamara","family":"Ritt-Olson","sequence":"additional","affiliation":[{"name":"Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5280-990X","authenticated-orcid":false,"given":"David R.","family":"Freyer","sequence":"additional","affiliation":[{"name":"Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA"},{"name":"Children's Hospital Los Angeles, Los Angeles, CA"},{"name":"USC Norris Comprehensive Cancer Center, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0742-3730","authenticated-orcid":false,"given":"Kimberly A.","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA"},{"name":"Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanie M.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic, Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel","family":"Milam","sequence":"additional","affiliation":[{"name":"Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA"},{"name":"Department of Epidemiology and Biostatistics, University of California Irvine, Irvine, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4391-4219","authenticated-orcid":false,"given":"Alexandre","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy Practice, School of Pharmacy & Pharmaceutical Sciences, University of California Irvine, Irvine, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"b1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.57.7528"},{"key":"b2","doi-asserted-by":"publisher","DOI":"10.1002\/pon.5456"},{"key":"b3","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.20.02533"},{"key":"b4","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.76.4696"},{"key":"b5","doi-asserted-by":"publisher","DOI":"10.1089\/jayao.2020.0086"},{"key":"b6","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.21992"},{"key":"b7","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-020-05860-9"},{"key":"b8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2014.12.017"},{"key":"b9","volume-title":"Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent and Young Adult Cancers. 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